Joint and independent effects of maternal prenatal depression and SARS-CoV-2 exposure on infant cognitive and socioemotional development across the first postnatal year

Here we evaluate longitudinal neurodevelopmental trajectories across the first postnatal year in infants of mothers impacted by the COVID-19 pandemic during pregnancy. Ninety-three pregnant mothers were recruited beginning at the first peak of the pandemic in New York City, and were oversampled for SARS-CoV-2 exposure during pregnancy (n = 36 COVID-19 exposed mothers). At 6 months postpartum, infant attentional processing was measured remotely using an online webcam-linked eye tracker developed for infant remote research in the home environment. At 12 months, infant socioemotional development was evaluated through maternal-report using validated surveys. Results indicated that interactions between maternal depressive symptoms and SARS-CoV-2 exposure during pregnancy were linked with individual differences in infants’ attentional processing at 6 months of age. Specifically, in mothers reporting positive exposure to SARS-CoV-2, higher prenatal depressive symptoms were associated with attentional patterns characterized by increased orienting to salient stimuli, longer looking times, and lower levels of maternal-reported measures of attentional control. In turn, these attentional patterns subsequently predicted socioemotional competence at 12 months, over and beyond individual contributions of prenatal depression, SARS-CoV-2 exposure, or relevant infant or family characteristics. These findings provide preliminary evidence of phenotypic adaptations in attentional processing by infants of mothers affected by the COVID-19 pandemic, and highlight infant attentional processing as a relevant early behavioral predictor of longitudinal developmental trajectories.

Prenatal depression exposure alters white matter integrity and neurodevelopment in early childhood

Prenatal exposure to maternal depression increases the risk for onset of emotional and behavioral disorders in children. We investigated the effects of exposure to prenatal depression on white matter microstructural integrity at birth and at 2-3 years, and associated neurodevelopment. Diffusion-weighted images were acquired for children of the Drakenstein Child Health Study at 2-4 weeks postpartum (n=70, 47% boys) and at 2-3 years of age (n=60, 58% boys). Tract-Based Spatial Statistics was used to compare, using an ROI based approach, diffusion tensor metrics across groups defined by presence (>19 on Beck’s Depression Inventory and/or >12 on the Edinburgh Postnatal Depression Scale) or absence (below depression thresholds) of depression, and associations with neurodevelopmental measures at age 2-3 years were determined. We did not detect group differences in white matter integrity at neonatal age, but at 2-3 years, children in the exposed group demonstrated higher fractional anisotropy, and lower mean and radial diffusivity in association tracts compared to controls. This was notable in the sagittal stratum (radial diffusivity: p<0.01). Altered white matter integrity metrics were also observed in projection tracts, including the corona radiata, which associated with cognitive and motor outcomes in exposed 2-3-year-olds (p<0.05). Our findings of widespread white matter alterations in 2-3-year-old children with prenatal exposure to depression are consistent with previous findings, as well as with neuroimaging findings in adults with major depression. Further, we identified novel associations of altered white matter integrity with cognitive development in depression-exposed children, suggesting that these neuroimaging findings may have early functional impact.

Association between Second-Time Mother’s Prenatal Depression and Firstborn’s Behaviour Problems: The Mediation Role of Parenting Daily Hassles

Background: With the relaxation of birth control policy in China in recent years, second-time mothers’ mental health has raised concerns. However, the impact of firstborn children’s behaviour problems on second-time mothers’ prenatal depression in families transitioning to siblinghood has received little attention from family psychologists. Aims: This research aims to investigate whether firstborn children’s behaviour problems affect second-time mothers’ prenatal depression and the mediation role of daily parenting hassles, i.e., minor stressors associated with parenting, on this relationship. Methods: Data about second-time mothers’ prenatal depression, parenting daily hassles, and firstborn children’s behaviour problems were collected from 105 families transitioning to two children families using mother-reported questionnaires. Regressions were used to analyze the data. Results: About half of the mothers in the sample have depressive symptoms. Firstborns’ behaviour problems did not have a direct effect on the mother’s prenatal depression, but the problems did have an indirect effect via parenting daily hassles. The mothers’ age was significantly associated with prenatal depression. Conclusions: The mediation role of parenting daily hassles in the association with firstborn’s behaviour problems and mother’s prenatal depression suggests the need for support that reduce the levels of daily parenting hassles from firstborn children.

Association between maternal depression during pregnancy and newborn DNA methylation

Around 15–65% of women globally experience depression during pregnancy, prevalence being particularly high in low- and middle-income countries. Prenatal depression has been associated with adverse birth and child development outcomes. DNA methylation (DNAm) may aid in understanding this association. In this project, we analyzed associations between prenatal depression and DNAm from cord blood from participants of the South African Drakenstein Child Health Study. We examined DNAm in an epigenome-wide association study (EWAS) of 248 mother-child pairs. DNAm was measured using the Infinium MethylationEPIC (N = 145) and the Infinium HumanMethylation450 (N = 103) arrays. Prenatal depression scores, obtained with the Edinburgh Postnatal Depression Scale (EPDS) and the Beck Depression Inventory-II (BDI-II), were analyzed as continuous and dichotomized variables. We used linear robust models to estimate associations between depression and newborn DNAm, adjusted for measured (smoking status, household income, sex, preterm birth, cell type proportions, and genetic principal components) and unmeasured confounding using Cate and Bacon algorithms. Bonferroni correction was used to adjust for multiple testing. DMRcate and dmrff were used to test for differentially methylated regions (DMRs). Differential DNAm was significantly associated with BDI-II variables, in cg16473797 (Δ beta = −1.10E-02, p = 6.87E-08), cg23262030 (Δ beta per BDI-II total IQR = 1.47E-03, p = 1.18E-07), and cg04859497 (Δ beta = −6.42E-02, p = 1.06E-09). Five DMRs were associated with at least two depression variables. Further studies are needed to replicate these findings and investigate their biological impact.

Predictors of Prenatal Depression: A Cross-Sectional Study in Rural Pakistan

Objective: To determine the prevalence and association of prenatal depression with socioeconomic, demographic and personal factors among pregnant women living in Kallar Syedan, Rawalpindi, Pakistan.Methods: Five hundred women in the second and third trimester of pregnancy, living in Kallar Syedan, a rural area of district Rawalpindi Pakistan, were included in the study. Depression was assessed using “Patient health questionnaire” (PHQ9) in Urdu, with a cut-off score of 10. Multi-dimensional scale of perceived social support (MSPSS) was used to assess perceived social support. Life Events and Difficulties Schedule (LEDS) were used to measure stressful life events in past 1 year. Tool to assess intimate partner violence (IPV) was based on WHO Multi Country Study on “Women's Health and Domestic Violence against Women.”Results: Prevalence of prenatal depression was found to be 27%. Number of pregnancies was significantly associated with prenatal depression (p &lt; 0.01). Women living in a joint family and those who perceived themselves as moderately satisfied or not satisfied with their life in the next 4 years were found to be depressed (p &lt; 0.01, OR 6.9, CI 1.77–26.73). Depressive symptomatology in women who experienced more than five stressful life events in last 1 year was three times higher (p &lt; 0.001, OR 3.2, CI 1.68–5.98) than in women with 1–2 stressful events. Women who were supported by their significant others or their family members had 0.9 times (p &lt; 0.01, OR 0.9, CI 0.85–0.96) less chance of getting depressed. Pregnant women who were psychologically abused by their partners were 1.5 times more depressed (p &lt; 0.05 CI 1.12–2.51). Odds of having depression was also high in women who had less mean score of MSSI (p &lt; 0.05, OR 1.1, CI 1.01–1.09). Women who had suitable accommodation had 0.5 times less chance of having depression than others (p &lt; 0.05, OR 0.5, CI 0.27–0.92).Conclusion: Over a quarter of the women in the study population reported prenatal depression, which were predicted predominantly by psychosocial variables.

Prenatal Depression Exposure Alters White Matter Integrity and Neurodevelopment in Early Childhood

Prenatal exposure to maternal depression increases the risk for onset of emotional and behavioral disorders in children. Here, we investigated the effects of exposure to prenatal depression on white matter microstructural integrity at birth and at 2–3 years, and associated neurodevelopment. Diffusion-weighted images were acquired for children of the Drakenstein Child Health Study at 2–4 weeks postpartum (n = 70, 47% boys) and at 2–3 years of age (n = 60, 58% boys). Tract-Based Spatial Statistics was used to compare diffusion tensor metrics across groups defined by presence (> 19 on Beck’s Depression Inventory and/or > 12 on the Edinburgh Postnatal Depression Scale) or absence (below depression thresholds) of depression, and associations with neurodevelopmental measures at age 2–3 years were determined. We did not detect group differences in white matter integrity at neonatal age in this cohort, but at 2–3 years, children in the exposed group demonstrated higher fractional anisotropy, and lower mean and radial diffusivity in association tracts compared to control children. This was notable in the sagittal stratum (radial diffusivity: p < 0.01). Altered white matter integrity metrics were also observed in projection tracts, including the corona radiata, which associated with cognitive and motor outcomes in exposed 2-3-year-olds (p < 0.05). Our findings of widespread white matter alterations in 2-3-year-old children with prenatal exposure to depression are consistent with previous findings, as well as with neuroimaging findings in adults with major depression. Further, we identified novel associations of altered white matter integrity with cognitive development in depression-exposed children, suggesting that these neuroimaging findings may have early functional impact.

Prenatal Depression, Breastfeeding, and Infant Gut Microbiota

Depressive symptoms are common during pregnancy and are estimated to affect 7–20% of pregnant women, with higher prevalence found in those with a prior history of depression, in ethnic minorities, and those with increased exposure to stressful life events. Maternal depression often remains undiagnosed, and its symptoms can increase adverse health risks to the infant, including impaired cognitive development, behavioral problems, and higher susceptibility to physical illnesses. Accumulating research evidence supports the association between maternal physical health elements to infant gut health, including factors such as mode of delivery, medication, feeding status, and antibiotic use. However, specific maternal prenatal psychosocial factors and their effect on infant gut microbiota and immunity remains an area that is not well understood. This article reviews the literature and supplements it with new findings to show that prenatal depression alters: (i) gut microbial composition in partially and fully formula-fed infants at 3–4 months of age, and (ii) gut immunity (i.e., secretory Immunoglobulin A) in all infants independent of breastfeeding status. Understanding the implications of maternal depression on the infant gut microbiome is important to enhance both maternal and child health and to better inform disease outcomes and management.